[Plasmapheresis treatment in 3 simultaneously occurring autoimmune diseases: Hashimoto thyroiditis with hyperthyroidism, autoimmune thrombopenia and autoimmune hemolytic anemia]. / Plasmapheresebehandlung bei 3 simultan auftretenden Autoimmunerkrankungen: Hashimoto-Thyreoiditis mit Hyperthyreose, Autoimmunthrombopenie und autoimmunhämolytische Anämie.

ABSTRACT

A 49 year-old women with a 2-year history of a Coombs-positive autoimmune haemolytic anaemia was hospitalized with Hashimoto's thyroiditis and thyrotoxic crisis. The clinical course was further complicated by an autoimmune thrombocytopenia. Primary resection of the thyroid thus seemed to be too risky, so we decided to perform therapeutic plasma exchange. This led to clinical improvement, enabling us to perform a thyroidectomy. The present investigation reveals the high efficiency of plasmapheresis in the treatment of combined autoimmune diseases. Therapeutic plasma exchange resulted in a reduction of both the relevant autoantibodies and the level of circulating thyroid hormones.